| Objective To analysis the expression of immune inflammatory factors like caudal type homeobox transcription factor 2(CDX-2),heparin-binding EGF-like growth factor(HB-EGF),bone morphogenetic protein 4(BMP-4)in the squamous epithelium of normal healthy subject,chronic reflux esophagitis(RE),barrett's esophagus(BE),RE and BE after treetment with proton pump inhibitors and investigate the correlation between them.Meanwhile,to analysis the effect of treetment on the expression level of CDX-2,HB-EGF and BMP-4,in order to explore the function and significance of CDX-2,HB-EGF and BMP-4 in BE.Methods 116 patients who all received gastroscopy and biopsy were enrolled in the study from endoscopy room of the General Hospital,Tianjin Medical University from May 2006 to September 2013.They were divided into groups of the squamous epithelium of normal healthy subject,RE,BE,RE and BE after treetment of proton pump inhibitors,according to under gastroscope performance and the results of hematoxylin-eosin staining.To detected the expression of CDX-2,HB-EGF and BMP-4 by immunohistochemical staining and then compare the different level of among the 5 groups.Meanwhile,further explore the correlation of CDX-2,HB-EGF and BMP-4 in BE.All statistical analysis were carried out with SPSS 17.0 and P<0.05 was considered significant.Results(1)The composition of sex and age was no significant difference in different groups.(2)The expression of CDX-2 increased in the squamous epithelium of normal healthy subject,RE and BE cases,corresponding to(0±0)?(43.1 ±10.6)and(67.8±11.3)per high magnification field,respectively.The levels of CDX-2 in RE and BE were significantly higher than that in the squamous epithelium of normal healthy subject(P<0.01).And,statistical significance was found in CDX-2 expression between RE and BE(P=0.000).(3)The increased expression of HB-EGF in RE and BE(corresponding to 39.4 ± 13.5 and 55.8 ± 13.9 per high magnification field,respectively)had a statistical significance(P<0.01),and they were all higher than that in the squamous epithelium of normal healthy subject(6.4 ± 1.4 per high magnification field)(P<0.01).(4)The expression of BMP-4 increased in the squamous epithelium of normal healthy subject,RE and BE cases,corresponding to(0±0),(22.6±6.4)and(25.1 ± 10.4)per high magnification field,respectively.The levels of BMP-4 in RE and BE were significantly higher than that in the squamous epithelium of normal healthy subject(P<0.01).However,no statistical significance was found in BMP-4 expression between RE and BE(P=0.910).(5)The levels of CDX-2,HB-EGF and BMP-4 expression were obviously down-regulated in RE after treetment with proton pump inhibitors(corresponding to 21.7±1.7,16.6±5.0 and 9.25±1.0 per high magnification field,respectively),comparing with that in RE(P=0.005,P=0.000 and P=0.006,respectively).And The levels of CDX-2,HB-EGF and BMP-4 expression were obviously down-regulated in BE after treetment with proton pump inhibitors(corresponding to 21.7±1.7,16.6±5.0 and 9.25±1.0 per high magnification field,respectively),comparing with that in BE(P=0.000,P=0.000 and P=0.000,respectively)(6)The positive rate of CDX-2,HB-EGF and BMP-4 expression were significantly higher in BE group than in RE group(P=0.000,P=0.012,P=0.000).Conclusion(1)CDX-2,HB-EGF and BMP-4 up-regulated in the development of normal squamous epithelium—RE--BE suggested that CDX-2,HB-EGF and BMP-4 played an important role in the development of BE.(2)After treetment with proton pump inhibitors,the levels of CDX-2,HB-EGF and BMP-4 expression were obviously down-regulated in RE and BE.It is possible that CDX-2,HB-EGF and BMP-4 play an important role in originate and development of BE(3)The expression of CDX-2,HB-EGF and BMP-4 in RE and BE were significantly higher than that in the squamous epithelium of normal healthy subject,that indicated the close relationship between RE and BE,and further confirmed that RE might be a stage of BE.(4)The expression and positive rate of CDX-2,HB-EGF and BMP-4 in RE and BE were positively correlated,which suggested they could promote the expression each other through direct or indirect way and had a synergistic effect.(5)CDX-2,HB-EGF and BMP-4 may become the gene targets for treatment and early intervention of BE and precancerous lesions through genetic engineering technology. |
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